Ringing in the Ears

Definition

Tinnitus is the perception of abnormal ear or head noises without any external sound. Noises may be high pitched, ringing, clicking, or buzzing. Pulsatile tinnitus is caused by the flow of blood that accompanies each heartbeat.

Blood vessel disorders, such as an aneurysm, fistula, or hardening of the arteries are associated with pulsatile tinnitus

Fluid in the ear

Ruptured membrane in the ear

Injury to the head or neck

Symptoms

The sensations of tinnitus may have the following characteristics:

Ringing, roaring, buzzing, whistling, or hissing sounds

Intermittent, continuous, or pulsatile quality

Same or varying intensity

Single or multiple tones

More annoying symptoms at night or when there are fewer distractions

Sensation of normal internal events, such as blood pulsing or muscles contracting

Sometimes tinnitus is accompanied by hearing loss and
vertigo, a sensation of spinning while standing still.

When Should I Call My Doctor?

Call your doctor if you have tinnitus, especially if it:

Is associated with hearing loss, vertigo, change in personality, speech, or weakness in any body area

Starts after head or neck injury

Is associated with new medication

Is pulsatile

Is associated with pain in the ear, fever, nausea, or vomiting

Is interfering with your activities

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Special attention will be paid to your head, neck, and ears.

You will be asked questions about:

The sensations that you have

The factors that may increase or decrease the sensation

The medications that you take

History of trauma

The doctor will look at your ear canal and eardrum using an instrument with a light that is held at the external opening of the ear. A tuning fork can help evaluate hearing. You should receive a complete hearing test. Imaging tests, such as a
CT
or
MRI scan, may be ordered to rule out serious conditions.

In addition to hearing the test may include:

Tympanogram

Auditory brain response

Electrocochleoraphy—to test for Meniere's disease

Treatment

Tinnitus treatment depends on what is causing the symptoms. This may mean:

Wearing a specially made splint to help manage
temporomandibular joint disorder

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.